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Organization
PAYNE FAMILY DENTISTRY
Active
Organization
PAYNE FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ADRIENNE M JACKSON-PAYNE D.D.S (DENTIST/OWNER)
(901) 365-9054
Entity
Organization
Contact information
Practice address
3574 HICKORY HILL RD, MEMPHIS, TN 38115-3827
(901) 365-9054
Mailing address
3574 HICKORY HILL RD, MEMPHIS, TN 38115-3827
(901) 365-9054
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
5420
MO
1223G0001X
General Practice Dentistry
Primary
7038
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1881777670
—
TN
05
—
1992884845
—
TN
Enumeration date
07/05/2011
Last updated
07/05/2011
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